The Dilemma of Coeval Climate and Demographic Changes: Heat Risk Analysis for the German Hospital Care System

Current climate projections illustrate a drastic increase in the likelihood of heatwaves throughout the century. At the same time, population scenarios for many developed countries indicate a coeval rise in elderly population fraction, in particular, in rural areas. Research demonstrates that failing to consider projected changes in population and demographics leads to a significant underestimation of health burdens [1]. Thus, in addition to the fundamental increase in healthcare demand due to the increased baseline morbidity of older individuals, there are also additional infrastructural requirements to prepare for weather and climate change-related consequences. Incorporating population changes into climate projections is therefore crucial for a comprehensive assessment of heat-related health impacts.

Here, we pursue a risk analysis for Germany by mid-century by combining health-relevant heat indicators with demographic scenarios and data on the healthcare provision situation at the county level. Climate indicators are based on latest results from statistically-downscaled CMIP6 climate projections for Germany [2]. Demographic changes are inferred from socioeconomic model simulation conducted for the latest Climate Impact and Vulnerability Analysis by the German Federal Environment Agency, available at the county level until 2045 [3]. Data from the German Federal Statistical Office are used to depict the spatial healthcare provision in terms of the number of spatially-explicit emergency department beds. For the risk analysis selected literature-based heat indicators with demonstrated health impacts are evaluated and the potential consequences for the German hospital emergency care system are discussed. In particular, the unequal spatial distribution of risks for the elderly population as well as the “double exposure” dilemma for certain areas facing large demographic changes and intensified heatwaves are identified.

Interpreting the spatial-temporal pattern of German regional exposure of hospitals to future heatwaves and demographic changes will help health care practitioners and political decision makers to develop strategies to reduce heat-related health risks both in the short and long term.

References

[1] Vanos, J. K., Baldwin, J. W., Jay, O., & Ebi, K. L. (2020). Simplicity lacks robustness when projecting heat-health outcomes in a changing climate. Nature Communications, 11(1), 6079. https://doi.org/10.1038/s41467-020-19994-1

[2] Kreienkamp, F., Lorenz, P., & Geiger, T. (2020). Statistically Downscaled CMIP6 Projections Show Stronger Warming for Germany. Atmosphere, 11(11), Article 11. https://doi.org/10.3390/atmos11111245

[3] Buth, M., Kahlenborn, W., Greiving, S., Fleischhauer, M., Zebisch, M., Schneiderbauer, S., & Schause, I. (2017). Leitfaden für Klimawirkungs- und Vulnerabilitätsanalysen. Umweltbundesamt.